Council Update

December 1-2, 2016

Introducing New CPSO President

Dr. David Rouselle, an obstetrician/gynecologist at Southlake Regional Health Centre in Newmarket, became the College's President on December 2. Dr. Rouselle grew up in Parry Sound and graduated from Queen's medical school. Dr. Rouselle began his career as a family physician, completing a residency in that discipline at the University of Western Ontario before going on to complete his residency in obstetrics/gynecology at McMaster.

Dr. Rouselle has been a District 5 Council member since 2011. Before becoming a Council member, he was appointed Vice-Chair (obstetrics) of the College's Inquiries, Complaints and Reports Committee (ICRC). He held that position for four years, before becoming Chair of the ICRC in 2015.

Watch for an interview with Dr. Rouselle in the next issue of Dialogue.

Hamilton Orthopedic Surgeon Receives Council Award

Dr. Mohit Bhandari, a Hamilton orthopedic surgeon and an internationally recognized leader in clinical orthopedic trauma research and evidence-based orthopedic surgery, was presented with the Council Award in December.

Dr. Bhandari is Professor and Academic Head of the Division of Orthopedic Surgery at McMaster University. He is also the Canada Research Chair in Evidence-Based Orthopedic Surgery with the Canadian Institutes of Health Research.

He began his medical studies at the University of Toronto and did his residency in orthopedic surgery at McMaster University. Throughout his career, he has dedicated his work to helping people who suffer from musculoskeletal injuries as a result of trauma. That dedication has seen him take a leading role in evidence-based medicine and he is credited with driving an enormous amount of research that will transform the care of orthopedic patients.

Please read the article about Dr. Bhandari in the next issue of Dialogue.

Have Your Say

CPSO Consultations Underway

New drafts have been developed for both the Accepting New Patients and the Ending the Physician-Patient Relationship policies, and the College now wants to hear what you think.

Overall, the general expectations that are set out in the current policies have been maintained in the new drafts. For instance, as in the current Accepting New Patients policy, physicians must employ the first-come, first-served approach when accepting new patients into their practices. Content has been added to the policy to explain how the first-come, first-served approach applies in various practice contexts. It is also made explicit that introductory meetings such as 'meet-and-greet' appointments, or other tools such as medical questionnaires, must not be used by physicians to 'vet' prospective patients and determine whether to accept those patients into their practice. Please see the article in the upcoming Dialogue for more information, and provide your feedback on the draft Accepting New Patients policy.

The Ending the Physician-Patient Relationship draft policy has been reframed to focus more directly on the conflicts that can arise between a physician's professional and ethical obligation to provide care to an individual patient, and their additional obligations to staff, other patients, colleagues, and their own health. The draft is also now more explicit that the policy's expectations apply equally to physicians practising in all speciality areas, not only family medicine. Please read the article in the upcoming issue of Dialogue for more information, and provide your feedback on the draft Ending the Physician-Patient Relationship policy.

Applying the OHPIP Standards in Fertility Services Premises

In 2015, the government requested that the College establish a quality and inspections framework for out-of-hospital premises and hospitals offering fertility services. The College's Expert Panel on Fertility Services developed a draft document "Applying the Out-of-Hospital Premises Inspection Program (OHPIP) Standards in Fertility Services Premises." The document will help practitioners, who provide fertility services, plan for and participate in their inspection-assessments. The document is intended to be used in conjunction with the OHPIP Standards.

We are inviting feedback on the draft companion document from all stakeholders, including members of the medical profession, the public, health-system organizations and other health professionals.

Proposed $30 Membership Fee Increase

After reviewing the proposed budget for 2017, Council has recommended a $30 fee increase. This increase would bring the fee that a physician pays to renew an independent practice certificate of registration from $1,595 to $1,625.

Over the past five years, the College has increased the membership fee for an independent practice certificate by $75. This represents an average of 1.2% over those five years.

The College has the third lowest fee rate among the other medical regulatory authorities in Canada. The highest fee is in Alberta, at $1,960.

The increases over the five years (for 2015 there was no increase) have been necessary to meet the increasing activity at the College. The costs reflect the expansion of numerous quality improvement programs, particularly peer assessment, the increasing number of incapacity investigations and the sheer volume and increasing complexity of College investigations. It was noted that there has been an 18% increase in complaints over the previous year and a 16% increase in referrals to discipline. It was also noted that the College's resources are also stressed by continued efforts to meet the increased demands of a number of government reviews, ad hoc data requests and legislative amendments.

To meet these demands, Council is proposing the following:

Increasing the fee for an application for a certificate of registration for postgraduate education from 10% of the membership fee to 25%;

Increasing the fee for an application for a certificate of registration for independent practice from 50% of the membership fee to 60%;

Increasing the Certificate of Professional Conduct fee from $50 to $75 (this fee has not been increased since 2008);

Establishing an expedited review service fee for those registration applications that meet the requirements for a certificate of registration that are set out in the regulation. Applicants who wish to expedite the initial assessment of such applications to a service standard of less than 3 weeks will have the option to do so with the new fee. Expedited review does not include the time taken to issue a Certificate. Expedited service is not available for those applications that require review by the College’s Registration Committee.

the tariff rate of a day's discipline hearing by 10% (from $5,000 to $5,500);

the fee for an initial application for a Certificate of Incorporation from $350 to $400;

the fee for a renewal of a Certificate of Incorporation from $125 to $175.

As part of the effort to attract physicians to College work, Council approved a 1% inflationary increase in per diems for physician Council and Committee members. The increase is effective January 1, 2017.

Policy Updates

Marijuana for Medical Purposes

The College's Marijuana for Medical Purposes policy has been revised to reflect the federal government's updated regulations governing the medical use of marijuana.

Under the updated regulations, patients are now permitted to access marijuana in forms other than dried, including fresh buds and leaves, and cannabis oil. Patients are also now permitted to apply to Health Canada for authorization to grow their own supply of marijuana plants, or to designate someone to grow plants for them.

The new regulations do not change the role of the physician in authorizing patient access to marijuana for medical purposes. As before, physicians are still required to complete a medical document which is effectively equivalent to a prescription. The revised policy is available online.

Registration Policy Change

Council has approved the Registration Committee's recommendation to revise the existing Restricted Certificates of Registration for Exam Eligible Candidates policy to provide increased clarity regarding exam eligibility and subsequent applications. This would allow extensions only in exceptional circumstances.

The policy was originally designed to provide physicians three years to complete any outstanding examinations. The Committee has routinely approved requests from physicians to extend their restricted certificates of registration beyond three years to allow them to continue to write their outstanding examinations.

Recent changes from the certifying bodies, however, have put the College in a position where it is at risk of creating a permanent supervised class of certificate for individuals who continue to be unsuccessful in their attempts at completing the required examinations. The revised policy is available online.

Revised OHPIP Standards Approved

The proposed changes to the Standards document were circulated for external consultation between May and August of this year. Only specific sections of the OHPIP Standards that reference the role of the Medical Director were updated, including responsibilities related to infection control and quality assurance. Generally speaking, stakeholders expressed support for the proposed changes.